An update in ovaric cystic pediculated detached: an unusual clinical presentation

Dermoid ovarian cysts are the most common benign ovarian tumors, with teratomas being those that present a malignant behavior. In this particular case, the complications and clinical consequences of the concurrence between acute cholecystitis and a detached ovarian dermoid cyst attached to the common bile duct of a patient will be described and analyzed. Woman, 32 years old Nulliparous. He does not remember the common rashes of childhood Not pathologies worthy of note. For some weeks he has been complaining of epigastric pain especially immediately after the main meals. For the onset of sudden pain, go to the Emergency Department (ER) Performs blood tests, abdominal ultrasound and abdomen CT. The radiologist’s referral spoke of “distended thick-walled gallbladder containing a large stone in the infundibulum; right, large adnexal cyst”. Rapidly the surgical team will GB 18.000; GR 4500000; HB 13,2 g/dL; PCR 250; The surgical treatment was carried out in laparoscopy in two steps. first step: asportation of the right adnexal cyst. Second step: cholecystectomy. In a second time the H&E study of cystic demonstrated the presence of anatomopathological elements. Histological report: phlegmonous cholecystitis & dermoid cyst. Patient evolves favorably without relapses. These cysts, unlike teratomas, have a very larval growth behavior, with little growth over time and very rarely bleed, generating their clinical manifestations after many years and being found by chance in clinical pictures such as acute cholecystitis, appendicitis and in some cases. peritonitis cases due to contamination of its structure and inflammation caused by another picture and in pregnant women in which the disease is found as a finding. The importance of adequately laparoscopic bag surgery versus an invasive excisional surgery defined the prognostic and relapse of these tumors in the woman. The larval growth of this type of tumor with the consequent strangulation and spillage of its content into the peritoneum will require adequate laparoscopic or excisional surgical management, taking care not to spread the tumor content of the cyst to the peritoneum, and subsequent study and follow-up of the patient.